The Golden Rule of Health Care
"The Golden Rule of Health Care" was the 51st Special Comment delivered on Countdown with Keith Olbermann, airing on 16 December 2009. The Comment Finally, as promised, a Special Comment on the latest version of HR 3590, the Senate Health Care Reform bill. To again quote Churchill after Munich, as I did six nights ago on this program: "I will begin by saying the most unpopular and most unwelcome thing: that we have sustained a total and unmitigated defeat, without a war." Last night on this program Howard Dean said that with the appeasement of Mr. Lieberman of Connecticut by the abandonment of the Medicare Buy-in, he could no longer support H-R 35-90. Dr. Dean's argument is informed, cogent, heart breaking, and unanswerable. Seeking the least common denominator, Sen. Reid has found it, especially the "least" part. This is not health, this is not care, this is certainly not reform. I bless the Sherrod Browns and Ron Wydens and Jay Rockefellers and Sheldon Whitehouses and Anthony Weiners and all the others who have fought for real reform and I bleed for the pain inflicted upon them and their hopes. They have done their jobs and served their nation. But through circumstances beyond their control, they are now seeking to reanimate a corpse killed by the Republicans, and by a political game played in the Senate and in the White House by men and women who have now proved themselves poorly equipped for the fight. The "men" of the current moment, have lost to the "mice" of history. They must now not make the defeat worse by passing a hollow shell of a bill just for the sake of a big-stage signing ceremony. This bill, slowly bled to death by the political equivalent of the leeches that were once thought state-of-the-art-medicine, is now little more than a series of microscopically minor tweaks of a system which is the real-life, here-and-now version, of the malarkey of the Town Hallers. The American Insurance Cartel is the Death Panel, and this Senate bill does nothing to destroy it. Nor even to satiate it. It merely decrees that our underprivileged, our sick, our elderly, our middle class, can be fed into it, as human sacrifices to the great maw of corporate voraciousness, at a profit per victim of 10 cents on the dollar instead of the current 20. Even before the support columns of reform were knocked down, one by one, with the kind of passive defense that would embarrass a touch-football player - single-payer, the public option, the Medicare Buy-In - before they vanished, the Congressional Budget Office estimated that the part of this bill that would require you to buy insurance unless you could prove you could not afford it, would cost a family of four with a household income of 54-thousand dollars a year, 17 percent of that income. Nine thousand dollars a year. Just for the insurance! That was with a public option. That was with some kind of check on the insurance companies. That was before — as Howard Dean pointed out — the revelation that the cartel will still be able to charge older people more than others; will — at the least — now be able to charge much more, maybe 50 percent more, for people with pre-existing conditions — pre-existing conditions; you know, like being alive. You have just agreed to purchase a product. If you do not, you will be breaking the law and subject to a fine. You have no control over how much you will pay for the product. The government will have virtually no control over how much the company will charge for the product. The product is designed like the Monty Python sketch about the insurance company's "Never-Pay" policy ... "which, you know, if you never claim — is very worthwhile. But you had to claim, and, well, there it is." And who do we have to blame for this? There are enough villains to go around, men and women who, in a just world, would be the next to get sick and have to sell their homes or their memories or their futures — just to keep themselves alive, just to keep their children alive, against the implacable enemy of American society, the insurance cartel. Mr. Grassley of Iowa has lied, and fomented panic and fear. Mr. DeMint of South Carolina has forgotten he represents people, and not just a political party. Mr. Baucus of Montana has operated as a virtual agent for the industry he is charged with regulating. Mr. Nelson of Nebraska has not only derailed reform, he has tried to exploit it to overturn a Supreme Court decision that, in this context, is frankly none of his goddamned business. They say they have done what they have done for the most important, the most fiscally prudent, the most gloriously phrased, the most inescapable of reasons. But mostly they have done it for the money. Lots and lots of money from the insurance companies and the pharmacological companies and the other health care companies who have slowly taken this country over. Which brings us to Mr. Lieberman of Connecticut, the one man at the center of this farcical perversion of what a government is supposed to be. Out of pique, out of revenge, out of betrayal of his earlier wiser saner self, he has sold untold hundreds of thousands of us into pain and fear and privation and slavery — for money. He has been bought and sold by the insurance lobby. He has become a Senatorial prostitute. And sadly, the President has not provided the leadership his office demands. He has badly misjudged the country's mood at all ends of the spectrum. There is no middle to coalesce here, Sir. There are only the uninformed, the bought-off, and the vast suffering majority for whom the urgency of now is a call from a collection agency or a threat of rescission of policy or a warning of expiration of services. Sir, your hands-off approach, while nobly intended and perhaps yet some day applicable to the reality of an improved version of our nation, enabled the national humiliation that was the Town Halls and the insufferable Neanderthalian stupidity of Congressman Wilson and the street-walking of Mr. Lieberman. Instead of continuing this snipe-hunt for the endangered and possibly extinct creature "bipartisanship," you need to push the Republicans around or cut them out or both. You need to threaten Democrats like Baucus and the others with the ends of their careers in the party. Instead, those Democrats have threatened you, and the Republicans have pushed you and cut you out. Mr. President, the line between "compromise" and "compromised" is an incredibly fine one. Any reform bill enrages the right, and provides it with the war cry around which it will rally its mindless legions in the midterms and in '12. But this Republican knee-jerk inflexibility provides an incredible opportunity to you, Sir, and an incredible license. On April 6th 2003, I was approached by two drunken young men at a baseball game. One of them started to ask for an autograph. The other stopped him by shouting "Screw him, he's a liberal." This program had been on the air for three weeks. It had to that point consisted entirely of brief introductions to correspondents in Iraq or to military analysts. There had been no criticism, no political analysis, no commentary. I had not covered news full-time for more than four years. I could not fathom on what factual basis, I was being called a "liberal," let alone being sworn at for being such. Only later did it dawn on me that it didn't matter why, and it didn't matter that they were doing it — it only mattered that if I was going to be mindlessly criticized for anything, the reaction would be identical whether I did nothing that engendered it, or stood for something that engendered it. Mr. President, they are calling you a socialist, a communist, a Marxist. You could be further to the right than Reagan - and this health care bill, as Howard Dean put it here last night, this bailout for the insurance industry, sure invites the comparison. And they will still call you names. Sir, if they are going to call you a socialist no matter what you do, you have been given full unfettered freedom to do what you know is just. The bill may be the ultimate political manifesto, or it may be the most delicate of compromises. The firestorm will be the same. So why not give the haters, as the cliché goes, something to cry about. But concomitant with that is the reaction from Democrats and Independents. You have riven them, Sir. Any bill will engender criticism but this bill costs you the left — and anybody who now has to pony up 17 percent of his family's income to buy this equivalent of Medical Mobster Protection Money. Some speaking for you, Sir, have called the public option a fetish. They may be right. But to stay with this uncomfortable language, this bill is less fetish, more bondage. Nothing short of your re-election and the re-election of dozens of Democrats in the house and senate, hinges in large part on this bill. Make it palatable or make it go away or make yourself ready — not merely for a horrifying campaign in 2012 — but for the distinct possibility also of a primary challenge. Befitting the season, Sir, these are not the shadows of the things that will be, but the shadows of the things that may be. But at this point, Mr. President, only you can make certain of that. There is only one redemption possible. The mandate in this bill under which we are required to buy insurance must be stripped out. The bill now is little more than a legally mandated delivery of the middle class (and those whose dreams of joining it slip ever further away) into a kind of Chicago stockyards of insurance. Make enough money to take care of yourself and your family and you must buy insurance — on the insurers terms — or face a fine. This provision must go. It is, above all else, immoral and a betrayal of the people who elected you, Sir. You must now announce that you will veto any bill lacking an option or buy-in, but containing a mandate. And Sen. Reid, put the public option back in, or the Medicare Buy-In, or both. Or single-payer. Let Lieberman and Ben Nelson and Baucus and the Republicans vote their lack-of-conscience and preclude 60 "ayes." Let them commit political suicide instead of you. Let Mr. Lieberman kill the bill — then turn to his Republican friends only to find out they hate him more than the Democrats do. Let him stagger off the public stage, to go work for the insurance industry. As if he is not doing that now. Then, Mr. Reid, take every worthwhile provision of health care reform you legally can, and pass it via reconciliation, when ever and how ever you can — and by the way, a Medicare Buy-In can be legally passed via reconciliation. The Senate bill with the mandate must be defeated, if not in the Senate, then in the House. Health care reform that benefits the industry at the cost of the people is intolerable and there are no moral constructs in which it can be supported. And if still the bill and this heinous mandate become law there is yet further reaction required. I call on all those whose conscience urges them to fight, to use the only weapon that will be left to us if this bill becomes law. We must not buy federally mandated insurance if this cheesy counterfeit of reform is all we can buy. No single payer? No sale. No public option? No sale. No Medicare buy-in? No sale. I am one of the self-insured, albeit by choice. And I hereby pledge that I will not buy this perversion of health care reform. Pass this at your peril, Senators, and sign it at yours, Mr. President. I will not buy this insurance. Brand me a lawbreaker if you choose. Fine me if you will. Jail me if you must. But if the Medicare Buy-In goes, but the Mandate stays, the people who fought so hard and so sincerely to bring sanity to this system must kill this mutated version of their dream, because those elected by us to act for us have forgotten what must be the golden rule of health care reform. It is the same one to which physicians are bound, by oath: First do no harm. See Also Golden Rule of Health Care